血管性痴呆患者事件相关电位P300的实验

背景在对血管性痴呆的诊断和治疗效果的评价过程中,最突出的问题是缺乏一种客观、敏感的手段来评估患者的痴呆程度及其变化,以便及时对患者作出诊断或对其疗效进行考核.事件相关电位的内源成分P300,与受试者的认知加工过程密切相关,而与刺激的性质无关,是客观反映大脑高级心理活动最有价值的可靠指标之一.目的探讨事件相关电位P300对血管性痴呆患者的作用和意义,为血管性痴呆的临床诊断和疗效考核提供客观依据.设计以患者为研究对象,非随机同期化对照的验证性研究.单位一所省级医院的神经内科和肌电图室和一所大学医院的神经内科.对象2000-02/2001-06重庆医科大学附属第二医院神经内科门诊及住院的血管性痴呆患者64例(血管性痴呆组),其中,男38例,女26例,平均年龄(66.0±4.6)岁.文化程度中学以上19人,小学31例,文盲14例.同期住院的未发生血管性痴呆的脑卒中患者60例(非血管性痴呆组),其中,男35例,女25例,平均年龄(68.0±3.7)岁.文化程度中学以上15例,小学29例,文盲16例.方法用简易智能量表考核血管性痴呆组和非血管性痴呆组患者的智能状况,并对其进行P300检测,观察患者P300的潜伏期及波幅的改变,并比较二者在血管性痴呆组和非血管性痴呆组患者间的差异,同时观察患者P300潜伏期与简易智能量表得分相关性.主要观察指标P300的潜伏期及波幅的改变.P300潜伏期与简易智能量表得分相关性.结果血管性痴呆组和非血管性痴呆组患者P300潜伏期延长率分别为74%和7%,两组患者间差异有显著性,同时患者P300潜伏期与简易智能量表得分有明显相关性(r=0.6096,P＜0.05).结论P300潜伏期可以作为血管性痴呆患者早期诊断和疗效考核的客观指标.

P300 event-related potential of patients with vascular dementia

BACKGROUND:It is crucial for us to find an objective and sensitive means for the assessment ofthe severitv and development of dementia,so as to make instant diagnosis and examination of therapeutic effect on patientswith vascular dementias(VD).Event related potential endogenetic eomponent P300 is proved closely correlated with the cognitive management of examinees but not with stimulus property,thereby considered as one of the most valuable and objective index for brain superior psychological activity.OBJECTIVE:To study the role and significance of events related potential P300,providing objective basis for clinical diagnosis and therapeutic assessment for patients with VD.DESIGN:Non-randomized simultaneous controlled explorative study based on patients. SETTING:Neurological department and electromyography department in aprovincial hospital and neurological department in a medical college hospital.PARTICIPANTS:Between February 2000 and June 2001,64 patients were of VD at neurological clinic and ward ofthe Second Affiliated Hospital of Chongqing Medical College,including 38 males and 26 females with theaverage age of(66.0±4.6)years(VD group).Culturallevel:19 cases re-ceiyed over senior school education,31 cases of junior school education and14 cases of illiteracy.Meanwhile 60 inpatients without VD were enrolled(non-VD group)including 35 males and 25 females withthe average age of(68.0±3.7)years.Culturallevel:senior school or above,15 cases,junior school, 29 cases and illiteracy,16 cases.METHODS:Mental sate of both VD and non-VD groups were assessed with mini-mental state examination(MMSE),and tested with P300 potential observing the variability of latency and amplitude of P300 in patients.Both methods were compared between VD group and non-VD group, moreover relationship between P300 latency and MMSE scores was also explored.MAIN OUTCOME MEASURES:Variability of P300 latency and amplitude Relationship between P300 latency and MMSE scores.RESULTS:P300 latency was found prolonged in 74% and 7% of VD group and non-VD group respectively,with obvious significance between them,meanwhile prolonged P300 latency was proved closely correlated with the MMSE scores(r=0.609 6,P＜0.05).CONCLUSION:P300 latency can be considered as an obiective predictor for the earlier diagnosis and the assessment of therapeutic effects in patients with VD.